H Pylori & Gastric Disease Flashcards
What is the presentation of dyspepsia?
Dyspepsia - Indigestion
Dyspepsia is often accompanied by:
Upper abdominal discomfort
Retrosternal pain
Anorexia
Nausea
Vomiting
Bloating
Fullness
Early satiety
Heartburn
What is the presentation of peptic ulcers?
Epigastric pain
Nocturnal pain
Back pain
Nausea
Weight loss and anorexia
What is the presentation of gastric outlet obstruction?
Vomiting - no bile, fermented foodstuff
Early satiety
Abdominal distension
Weight loss
Dehydration
What is the presentation of gastric cancer?
Dyspepsia
Early satiety
Nausea + vomiting
Weight loss
GI bleeding
Iron deficiency anaemia
What is the treatment for dyspepsia?
Stage 1 - >55 y.o. or ALARM symptoms?
Stage 2 - If yes, perform endoscopy
If no - stop drugs such as NSAID’s, lifestyle changes and try over counter antacids
Stage 3 - If no improvement and -ve test for H.Pylori, try PPI’s (omeprazole) or Histamine receptor antagonist
If no improvement with Step 2 and +ve for H.Pylori, start treatment to eradicate H.Pylori
What is the treatment for peptic ulcers?
Lifestyle - avoid aggravating foods, stop smoking
H.Pylori eradication - Triple therapy
Reduce acid - PPI’s
NSAID associated ulcers - STOP NSAID’s
How is gastric outlet obstruction treated?
Endoscopic baloon dilatation
Surgery
How is gastric cancer treated?
Surgery
Chemotherapy
What role does H.Pylori play in gastric disease?
Infects > 50% of world population
Bacteria present in all patients with chronic gastritis
The bacteria resides on the surface mucosal layer and can ONLY be found in gastric mucosa
How is H.Pylori disease treated?
Triple therapy
1) Clarithromycin
2) Amoxycilin
3) PPI (Omeprazole)
How is H.Pylori diagnosed?
13C Urea breath test
Stool antigen test (ELISA)
